Health inspection·March 3, 2025

F 0745 Provide medically-related social services to help each resident achieve the highest possible quality of life. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure the facility ' s social services department conducted residents ' psychosocial assessments upon admission for two of three sampled residents (Resident 2 and Resident 3) and failed to make follow up calls to residents after they were discharged home for three of three sampled residents. (Resident 1, Resident 2 and Resident 3) Residents Affected - Some These deficient practices had the potential to result in negative psychosocial outcomes a for Resident 2 and Resident 3 and had the potential to result in an unsafe discharge for Resident 1, Resident 2 and Resident 3. Findings: a. During a review of Resident 1 ' s admission Record, the admission Record indicated the facility admitted Resident 1 on 1/20/2025 with diagnoses that included non-displaced fracture (broken bone) of base of neck of the right femur (hip), history of falling, and difficulty in walking. During a review of Resident 1 ' s Minimum Data Set (MDS - a standardized assessment and screening tool) dated 1/6/2025, the MDS indicated Resident 1 ' s cognition (the mental action or process of acquiring knowledge and understanding through thought, experience, and the sense) was severely impaired. The MDS indicated Resident 1 required partial/moderate assistance with oral hygiene and required substantial/maximal assistance with toileting hygiene and shower/bathing self. During a review of Resident 1 ' s physician ' s order dated 2/5 2025, it indicated an order to discharge Resident 1 home with 24-hour care giver, on 2/13/2024. Noted on 2/11/2025. During a concurrent interview and record review with the Social Services Director (SSD) 3/3/2024 11:46 p.m., the SSD stated that after resident is discharged back into the community the SSD will make follow up phone calls to the resident to ensure that the resident made it home safe, to ensure the resident is adjusting well, and to ensure that home health has reached out to the resident. The SSD stated that Resident 1 was discharged home on 2/14/2025 with Resident 1 ' s family member. The SSD reviewed Resident 1 ' s social services progress notes and stated that there was no documented evidence of a follow up note after the discharge. The SSD stated that she did not make the follow up discharge phone call and that the SSD missed it. b.During a review of Resident 2 ' s admission Record, the admission Record indicated the facility admitted Resident 2 on 1/2/2025 with diagnoses that included metabolic encephalopathy (a broad term for any brain disease that alters brain function or structure), difficulty in walking, and abnormal (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 055142 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055142 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Magnolia Gardens Convalescent Hospital 17922 San Fernando Mission Rd Granada Hills, CA 91344 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)